We will perform a total of 20 simultaneous kidney-islet transplants. The first group will have the islets placed under the kidney capsule, the second group will have the islets injected intrahepatically via the portal vein. The recipients will be patients who kidney failure and have type 1 diabetes. Our research will help define the optimal candidates, immunosuppression, site, and feasibility of pancreatic islet transplantation. Prior to transplantation, c-peptide negativity will be verified using a glucagon challenge. At 1 week, 1 month, 3 months, 6 months, and yearly from 1-5 years, insulin secretion will be assessed using a sustacal meal challenge test.